Short-term corticosteroid therapy consecutive to hemodialysis and charcoal hemoperfusion for methotrexate-induced acute kidney injury in an elderly lymphoma patient

Abstract

Acute kidney injury (AKI) due to delayed methotrexate (MTX) elimination is a severe potential adverse event of high-dose (HD)-MTX treatment. However, no treatment for HD-MTX-induced AKI has been established. In addition, there are no reports of corticosteroids being administered for HD-MTX-induced AKI. Here, we report the case of a 77-year-old male with central nervous system lymphoma, who developed an AKI after the second course of HD-MTX. He underwent charcoal hemoperfusion and hemodialysis immediately after the development of the AKI. He also received short-term corticosteroid therapy due to inflammatory findings and a positive drug-induced lymphocyte stimulation test for MTX. Our case suggests that short-term corticosteroid therapy consecutive to hemodialysis and charcoal hemoperfusion may be useful for AKI induced by delayed MTX elimination even in the elderly.

Keywords

• Methotrexate
• Central nervous system lymphoma
• Charcoal hemoperfusion
• Acute kidney injury
• Elderly